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Procedure price report · Other gastrointestinal diagnostic procedures

Anal and rectal exam under anesthesia

CPT 45990the billing code this page is about

Diagnostic examination of the anus, rectum and surrounding area, including visual inspection, that requires general or spinal anesthesia.

Hospitals typically charge $897 cash for this outpatient procedure — the median across 960 hospitals that filed a usable cash price; the average of the middle 60% is $1,510. Most fall between $204 and $4,554 (20th–80th percentile).

Hospitals
960
States
49
Filings dated
Aug 2022 – Sep 2026
Computed
September 25, 2026
Prices checked
through September 24, 2026

Median: half of hospitals filed less, half more — and it is a price some hospital actually filed. Average of the middle 60%: the mean of the prices between the 20th and 80th percentiles. We never publish the plain average, the lowest or the highest price: the extremes in hospital price files are chargemaster artefacts, not prices anyone pays.

What hospitals charge, from cheapest to most expensive

Cash price percentiles, outpatient, across 960 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$153$232$897$3,597$7,189

The most expensive tenth of hospitals charges at least 47× what the cheapest tenth charges ($153 vs $7,189).

How the prices are spread

$113 – $176: 79 hospitals$113$176 – $274: 185 hospitals$274 – $428: 75 hospitals$274$428 – $667: 77 hospitals$667 – $1,041: 30 hospitals$667$1,041 – $1,623: 53 hospitals$1,623 – $2,531: 57 hospitals$1,623$2,531 – $3,947: 150 hospitals$3,947 – $6,155: 76 hospitals$3,947$6,155 – $9,599: 84 hospitals$6,155median $897price bands are equal on a log scale
Hospitals per price band (866 of 960 — the bands cover the 5th to 95th percentile)
FromToHospitals
$113$17679
$176$274185
$274$42875
$428$66777
$667$1,04130
$1,041$1,62353
$1,623$2,53157
$2,531$3,947150
$3,947$6,15576
$6,155$9,59984

Against Medicare

Medicare pays (OPPS 2026, national rate)$2,836
Median cash price$897
Cash as a multiple of Medicare0.32×

The Medicare figure is the national unadjusted OPPS rate for this code — what Medicare itself pays a hospital before local wage adjustment. It is a benchmark, not a price anyone is charged.

By state

The median cash price in each state, against the national median of $897.

Alaska: 6 hospitals filed a usable price — fewer than 10, so no figureAKMaine: median $184 across 11 hospitalsME$184Vermont: median $166 across 11 hospitalsVT$166New Hampshire: median $184 across 10 hospitalsNH$184Washington: median $786 across 34 hospitalsWA$786Idaho: median $3,047 across 12 hospitalsID$3,047Montana: median $287 across 11 hospitalsMT$287North Dakota: 4 hospitals filed a usable price — fewer than 10, so no figureNDMinnesota: median $347 across 34 hospitalsMN$347Illinois: median $459 across 40 hospitalsIL$459Wisconsin: median $562 across 37 hospitalsWI$562Michigan: median $266 across 43 hospitalsMI$266New York: median $860 across 48 hospitalsNY$860Massachusetts: median $2,556 across 17 hospitalsMA$2,556Oregon: median $308 across 29 hospitalsOR$308Nevada: 8 hospitals filed a usable price — fewer than 10, so no figureNVWyoming: 6 hospitals filed a usable price — fewer than 10, so no figureWYSouth Dakota: 3 hospitals filed a usable price — fewer than 10, so no figureSDIowa: median $264 across 42 hospitalsIA$264Indiana: median $277 across 20 hospitalsIN$277Ohio: median $5,092 across 41 hospitalsOH$5,092Pennsylvania: median $639 across 31 hospitalsPA$639New Jersey: median $3,554 across 34 hospitalsNJ$3,554Connecticut: 4 hospitals filed a usable price — fewer than 10, so no figureCTRhode Island: 1 hospital filed a usable price — fewer than 10, so no figureRICalifornia: median $3,046 across 60 hospitalsCA$3,046Utah: no hospital in the corpus filed a usable priceUTColorado: median $282 across 18 hospitalsCO$282Nebraska: median $245 across 17 hospitalsNE$245Missouri: median $460 across 26 hospitalsMO$460Kentucky: median $137 across 14 hospitalsKY$137West Virginia: median $386 across 20 hospitalsWV$386Virginia: median $3,402 across 15 hospitalsVA$3,402Maryland: 2 hospitals filed a usable price — fewer than 10, so no figureMDDelaware: 3 hospitals filed a usable price — fewer than 10, so no figureDEArizona: median $361 across 10 hospitalsAZ$361New Mexico: 9 hospitals filed a usable price — fewer than 10, so no figureNMKansas: median $218 across 24 hospitalsKS$218Arkansas: median $2,047 across 10 hospitalsAR$2,047Tennessee: median $2,364 across 20 hospitalsTN$2,364North Carolina: median $1,528 across 14 hospitalsNC$1,528South Carolina: median $3,945 across 22 hospitalsSC$3,945Oklahoma: median $220 across 19 hospitalsOK$220Louisiana: median $1,538 across 20 hospitalsLA$1,538Mississippi: median $617 across 10 hospitalsMS$617Alabama: median $2,680 across 11 hospitalsAL$2,680Georgia: median $1,137 across 11 hospitalsGA$1,137Hawaii: 5 hospitals filed a usable price — fewer than 10, so no figureHITexas: median $2,412 across 42 hospitalsTX$2,412Florida: median $5,088 across 21 hospitalsFL$5,088
Cash price by state, most expensive first. National median $897. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
Ohio OH41$5,092+467%$265 – $8,200
Florida FL21$5,088+467%$1,155 – $8,639
South Carolina SC22$3,945+340%$2,975 – $4,935
New Jersey NJ34$3,554+296%$3,035 – $5,339
Virginia VA15$3,402+279%$2,848 – $3,402
Idaho ID12$3,047+240%$874 – $7,189
California CA60$3,046+239%$544 – $9,979
Alabama AL11$2,680+199%$305 – $6,052
Massachusetts MA17$2,556+185%$1,652 – $6,945
Texas TX42$2,412+169%$225 – $4,682
Tennessee TN20$2,364+163%$107 – $3,104
Arkansas AR10$2,047+128%$237 – $2,653
Louisiana LA20$1,538+71%$783 – $4,262
North Carolina NC14$1,528+70%$282 – $5,622
Georgia GA11$1,137+27%$1,137 – $3,540
New York NY48$860−4%$218 – $3,295
Washington WA34$786−12%$207 – $5,547
Pennsylvania PA31$639−29%$69 – $5,610
Mississippi MS10$617−31%$77 – $2,703
Wisconsin WI37$562−37%$549 – $897
Missouri MO26$460−49%$165 – $2,766
Illinois IL40$459−49%$186 – $6,766
West Virginia WV20$386−57%$116 – $1,996
Arizona AZ10$361−60%$117 – $8,088
Minnesota MN34$347−61%$190 – $564
Oregon OR29$308−66%$194 – $4,664
Montana MT11$287−68%$202 – $467
Colorado CO18$282−69%$179 – $2,657
Indiana IN20$277−69%$137 – $554
Michigan MI43$266−70%$199 – $3,817
Iowa IA42$264−71%$210 – $329
Nebraska NE17$245−73%$192 – $439
Oklahoma OK19$220−75%$220 – $3,796
Kansas KS24$218−76%$177 – $748
Maine ME11$184−80%$109 – $406
New Hampshire NH10$184−80%$114 – $1,268
Vermont VT11$166−82%$142 – $273
Kentucky KY14$137−85%$100 – $262
New Mexico NM9not enough hospitals filed a usable price
Nevada NV8not enough hospitals filed a usable price
Alaska AK6not enough hospitals filed a usable price
Wyoming WY6not enough hospitals filed a usable price
Hawaii HI5not enough hospitals filed a usable price
Connecticut CT4not enough hospitals filed a usable price
North Dakota ND4not enough hospitals filed a usable price
Delaware DE3not enough hospitals filed a usable price
South Dakota SD3not enough hospitals filed a usable price
Maryland MD2not enough hospitals filed a usable price
Rhode Island RI1not enough hospitals filed a usable price

Hospitals like yours

The same distribution cut by the kind of hospital. Hospital type and ownership come from CMS; a hospital counts as part of a system when its price file is shared with at least one other hospital under the same brand. The national median is $897.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care652$2,364$220 – $5,610
Children’s16fewer than 20 hospitals
Critical access290$310$188 – $897
Ownership
For-profit79$2,708$266 – $6,334
Government215$374$210 – $3,245
Non-profit664$1,050$200 – $4,664
System affiliation
Part of a system715$1,352$220 – $4,990
Independent245$354$196 – $3,047

Cash price vs list price

Median list price (chargemaster)$844
Median cash price$897
Cash as a share of list, median hospital65%

At the typical hospital, asking for the cash price cuts the list price by about 35%. The share is the median of each hospital’s own cash ÷ list ratio, over hospitals that filed both — not the ratio of the two medians above.

The same procedure, inpatient

528 hospitals filed a usable inpatient cash price for this code. The median is $549 and the average of the middle 60% is $1,218; most fall between $188 and $3,945.

Cash price percentiles, inpatient, across 528 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$137$211$549$3,425$7,853

The most expensive tenth of hospitals charges at least 57× what the cheapest tenth charges ($137 vs $7,853).

Of the 584 hospitals that filed this code inpatient, 528 gave a usable cash price; 19 carried a plausibility flag, 0 filed a number their own filing marks as not a price, 0 gave an estimate, and 37 a list price only.

How complete is this

960 of the 3,956 hospitals with a price file in our corpus (24%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 1,056 hospitals that filed this code at all gave us
Usable cash price — counted960
Cash price carrying a plausibility flag — shown on the compare tool, excluded here52
A number the filing itself marks as not a price (a placeholder, a ratio) — excluded0
An estimate rather than a filed cash price — excluded6
A list price only, no cash figure — excluded38
Hospitals that filed this code1,056

Sections not shown for this setting

  • Since our last snapshot: there is no earlier snapshot at least 90 days older than this one yet.

We last checked these hospitals’ price files for changes between September 4, 2026 and September 24, 2026; the figures were computed September 25, 2026 from filings loaded through September 24, 2026. The percentiles and averages use only the “counted” row.

Related procedures

Part of the Other gastrointestinal diagnostic procedures family.

Hospitals file this code under descriptions such as Anrct Xm Surg Req Anes General Spi/Edrl Dx.

Method

Source
The machine-readable price files every U.S. hospital is required by CMS to publish, parsed per hospital. Nothing is surveyed, sampled or modelled.
What counts
One cash (self-pay) price per hospital for this code and setting. A hospital’s own filing can rule its number out — a placeholder, a “not applicable” note, a list price standing in for cash — and our plausibility checks can flag a price far below what every other hospital files. Both kinds are disclosed above and excluded from the statistics; on the compare tool a flagged price is still shown.
Statistics
Percentiles are discrete: each is a price some hospital filed. The average is the mean of the prices between the 20th and 80th percentiles. We never publish the plain mean, the minimum or the maximum. A state needs 10 hospitals and a segment 20 to show a figure; otherwise the row shows its count and no number. Medicare is the national unadjusted OPPS rate where one exists.
Names
Procedure names on these pages are our own plain-language titles, not the AMA’s copyrighted CPT descriptors. The code is the identity.

The full rules — sources, statistics, thresholds, limitations — are on the methodology page.

Download this page’s figures: JSON · CSV. Aggregates only — the per-hospital prices are on the compare tool.

Cite: HospitalRates.com, “Anal and rectal exam under anesthesia (CPT 45990) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-45990-anal-and-rectal-exam-under-anesthesia